| Digestive Disease Specialists | |
|
5350 Distinction Way Prescott AZ 86301-8418 | |
| (928) 445-4066 | |
| (928) 445-4345 |
| Full Name | Digestive Disease Specialists |
|---|---|
| Speciality | Internal Medicine |
| Location | 5350 Distinction Way, Prescott, Arizona |
| Authorized Official Name and Position | Richard Pleva (PRESIDENT) |
| Authorized Official Contact | 9284454066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Digestive Disease Specialists Po Box 11654 Prescott AZ 86304-1654 Ph: (928) 445-4066 | Digestive Disease Specialists 5350 Distinction Way Prescott AZ 86301-8418 Ph: (928) 445-4066 |
| NPI Number | 1285824664 |
|---|---|
| Provider Enumeration Date | 07/31/2007 |
| Last Update Date | 06/24/2013 |
| Medicare PECOS PAC ID | 8820073109 |
|---|---|
| Medicare Enrollment ID | O20040621001629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285824664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Richard Pleva |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194700914 PECOS PAC ID: 0941285159 Enrollment ID: I20051201000502 |
| Provider Name | Ching Wang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881795052 PECOS PAC ID: 7214931906 Enrollment ID: I20101028000882 |
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